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Background: Speech and language therapists (SLTs) provide interventions for inducible laryngeal obstruction (ILO) despite a current lack of evidence to inform intervention delivery. This study is the first step to develop an evidence-based intervention for ILO, using behaviour change theory and the Behaviour Change Technique Taxonomy version 1 (BCTTv1). Outcomes will inform the early development stage of a complex speech and language therapy intervention for ILO, enabling more precise reporting of ILO intervention studies, as per CONSORT guidelines. Aims: (1) To identify whether the BCTTv1 is a useful tool for characterising speech and language therapy interventions for ILO, based on existing literature, current practice and patient interviews. (2) To identify key behaviour change techniques (BCT) used within existing complex speech and language therapy interventions for ILO. Methods and Procedures: A five-phase study was conducted: (1) a systematic literature search of six electronic databases (Medline, EMBASE, CINAHL (EBSCO), Scopus, Trip, Web of Science) and grey literature between 2008 and 2020; (2) observations of six speech and language therapy intervention sessions; (3) a semi-structured interview with an SLT to validate the observed BCTTs; (4) consensus from four national expert SLTs regarding application of synthesised BCTT data to their own experiences of ILO interventions; and (5) patient engagement to review and comment on findings. Outcomes and Results: Forty-seven BCTs in total were coded across all three sources. Thirty-two BCTs were identified in clinical observations; 31 in interviews with SLTs and 18 in the literature. Only six BCT were identified in all three sources. Expert SLTs confirmed clinical application and relevance. Patients reported finding the concept of BCT challenging but highlighted the value of psychoeducation to support their understanding of symptoms and in turn to understand the rationale behind speech and language therapy intervention recommendations. Conclusion: This study indicates that the BCTTv1 is a suitable framework to identify and describe intervention components used within speech and language therapy interventions for ILO. A practice-research gap exists, reinforcing that existing literature does not capture the complexity of speech and language therapy intervention for ILO. Further research is needed to develop our understanding of the BCTs that support optimal behaviour change for this patient group.

Background: Speech and language therapists (SLTs) provide interventions for inducible laryngeal obstruction (ILO) despite a current lack of evidence to inform intervention delivery. This study is the first step to develop an evidence‐based intervention for ILO, using behaviour change theory and the Behaviour Change Technique Taxonomy version 1 (BCTTv1). Outcomes will inform the early development stage of a complex speech and language therapy intervention for ILO, enabling more precise reporting of ILO intervention studies, as per CONSORT guidelines. Aims: (1) To identify whether the BCTTv1 is a useful tool for characterising speech and language therapy interventions for ILO, based on existing literature, current practice and patient interviews. (2) To identify key behaviour change techniques (BCT) used within existing complex speech and language therapy interventions for ILO Methods and Procedures: A five‐phase study was conducted: (1) a systematic literature search of six electronic databases (Medline, EMBASE, CINAHL (EBSCO), Scopus, Trip, Web of Science) and grey literature between 2008 and 2020; (2) observations of six speech and language therapy intervention sessions; (3) a semi‐structured interview with an SLT to validate the observed BCTTs; (4) consensus from four national expert SLTs regarding application of synthesised BCTT data to their own experiences of ILO interventions; and (5) patient engagement to review and comment on findings. Outcomes and Results: Forty‐seven BCTs in total were coded across all three sources. Thirty‐two BCTs were identified in clinical observations; 31 in interviews with SLTs and 18 in the literature. Only six BCT were identified in all three sources. Expert SLTs confirmed clinical application and relevance. Patients reported finding the concept of BCT challenging but highlighted the value of psychoeducation to support their understanding of symptoms and in turn to understand the rationale behind speech and language therapy intervention recommendations. Conclusion: This study indicates that the BCTTv1 is a suitable framework to identify and describe intervention components used within speech and language therapy interventions for ILO. A practice–research gap exists, reinforcing that existing literature does not capture the complexity of speech and language therapy intervention for ILO. Further research is needed to develop our understanding of the BCTs that support optimal behaviour change for this patient group. What this paper adds: What is already known on the subject: There is growing recognition for the value of speech and language therapists (SLTs) in delivering complex interventions for patients with inducible laryngeal obstruction (ILO), including evidence to suggest that their intervention can improve quality of life for patients and reduce excessive healthcare use. There are, however, no randomised controlled trials in this field; thus it is unclear what constitutes the most effective intervention. What this study adds: This study demonstrates the complexity of speech and language therapy interventions for ILO and highlights the practice–research gap. It identifies a range of behaviour change techniques that are used in existing practice and captures patient views relating to the components identified within this study. What are the clinical implications of this work?: Findings highlight the value of providing education about factors that might be driving ILO symptoms and in turn the importance of sharing with patients the rationale for treatment recommendations that necessitate a change in their behaviours. Identified behaviour change techniques can be used when developing and implementing SLT interventions for ILO. [ABSTRACT FROM AUTHOR]

Introduction: The British Orthopaedic Association Standards for Trauma (BOAST 12) guidelines for the management of ankle fractures aims to optimize recovery and reduce complications. Within the emergency department (ED), they advised urgent reduction of clinically deformed ankles, with radiographs prior only if this would not cause an unacceptable delay. The primary aim of this study was to assess the effect of time to acceptable reduction on the risk of complications and time to definitive reduction. Methods: This was a retrospective observational study of patients presenting with ankle fracture dislocations between 2013 and 2017. Patients were divided into two groups with and without radiographs prior to reduction of their injury. Results: A total of 242 patients were identified. The time taken from arrival to achieving an acceptable reduction was significantly longer in patients who received pre-reduction radiographs versus patients who did not (184.5 min vs 82, p <.00). The key finding of this follow-up study was that the overall risk of complications and soft tissue complications was not associated with an increased time to reduction (p =.62). Time to definitive operative management was similar between the two sub-groups (immediate reduction 1 day vs 2, p =.72). Conclusion: This study has shown that the use of pre-reduction radiographs in the management of ankle fracture dislocations significantly increases the time to reduction. However, this is not associated with an increased risk of complications or a longer time to definitive management. Further research is needed into the prognostic effect of prolonged ankle dislocation on soft tissues and long-term functional outcome. [ABSTRACT FROM AUTHOR]

Objective: Manual jet ventilation is a specialized oxygenation and ventilation technique that is not available in all facilities due to lack of technical familiarity and fear of complications. The objective is to review our center's 15 year experience with low pressure low frequency jet ventilation (LPLFJV). Methods: Retrospective review of procedures utilizing LPLFJV from 2005 to 2019 were performed collecting patient demographic, surgery type and complications. Fisher exact test, Chi square, and t -test were used to determine statistical significance. Results: Four hundred fifty-seven patients underwent a total of 891 microlaryngeal surgeries—279 cases for voice disorders, 179 for lesions, and 433 for airway stenosis. The peak jet pressure for all cases did not exceed 20 psi and average peak pressure for the last 100 procedures in this case series was 14.9 ± 4.6 psi. The average lowest oxygen saturation for all cases was 95% ± 0.6%. Brief intubation was required in 154 cases (17%). Surgical duration was significantly longer for cases requiring intubation P <.001. The need for intubation was not associated with smoking or cardiopulmonary disease, but was strongly associated with body mass index (BMI). Intubation rates were 7% for normal weight (BMI < 25, N = 216), 13% for overweight (BMI 25-30, N = 282), 24% for obese (BMI 30-40, N = 342), and 37% for morbidly obese (BMI > 40, N = 52) patients. Three patients developed respiratory distress in the recovery unit and 2 patients required intubation. Conclusion: LPLFJV assisted by intermittent endotracheal intubation is an exceedingly safe and effective intraoperative oxygenation and ventilationmodality for a broad variety of laryngeal procedure. [ABSTRACT FROM AUTHOR]

Introduces a laboratory activity on biological diversity that focuses on mollusks and trees. (YDS)

Responds to a critique by Susan S. Goldsmith of the Massachusetts Comprehensive Assessment System (MCAS) English Language Arts tests, focusing on Goldsmith's critique of test development, uniform topic focus, use of open-response items, and lack of explicit testing in vocabulary and grammar. Goldsmith replies to the response, highlighting needed refinements of testing tasks. (SM)

Reports survey results of 126 students enrolled in first- or second-year biology courses concerning the effectiveness of different teaching methods within the lecture format. Indicates that the traditional, didactic lecture, although perceived as least effective, was regarded as highly effective when enhanced by active student involvement. Appendices include the surveys utilized and frequency graphs of responses. (22 references) (JJK)

Introduction Sinonasal melanomas are rare tumors with no comparative survival studies between Europe and the US. Objective To provide a population-based survival analysis between the two continents. Methods The European Cancer Registry (EUROCARE) and the United States Surveillance, Epidemiology, and End Results (SEER) databases were queried to identify patients diagnosed with sinonasal melanoma between 2000 and 2007. Relative survival (RS) data were grouped by age, gender, geographic region, extent of disease, and treatment modality. Results A total of 1,294 cases were identified between 2000 and 2007 (935 from EUROCARE-5 and 359 from SEER). Females were most commonly identified in Europe (56.4%) and in the US (54.9%). Patients over the age of 65 years comprised the greatest proportion of patients in Europe (70%) and in the US (71%). By region, Southern Europe had the highest 5-year RS (31.6%, 95% confidence interval [CI]=[21.3-42.5%]), and Eastern Europe the lowest (16.5%, [7.5-28.5%]). The aggregate European 5-year RSwas 25.4% [21.8-29.1%] and the U.S. was (29.7%, [23.6-36%]). Conclusions Althoughincreasing inincidence, sinonasalmelanomas remain rare. Women were more commonly affected. The most common age group was those older than 65 years, although age did not confer a prognostic value. The most common subsite was the nasal cavity followed by themaxillary sinus. Five-year RSwas similar between continents with an inverse relationship between extent of diseaseand survival. The treatment of choice throughout Europe and the US remains primarily surgical. [ABSTRACT FROM AUTHOR]

This language production experiment sought to provide insight into workers' directness and facework strategies when confronting another employee about the understudied unethical act (Graham & Cooper, 2013) of idea stealing in the workplace. Participants included 326 full-time working adults, each of whom were randomly assigned to one of nine conditions in which they were asked to form a response to a hypothetical idea thief. Conditions varied based on two workplace relationship factors--the hierarchical relationship between the confronter and confronted and the relational closeness between the confronter and confronted. The implicitness-explicitness of confrontations was impacted by hierarchy, in that peer coworkers-confronting-peer coworkers and supervisors-confronting-subordinates were significantly more explicit in their confrontations than subordinates-confronting-supervisors. There were no significant differences in confrontational explicitness based on whether the transgressor was a troublesome other, acquaintance, or friend. Study data support the notion that in cases of idea stealing, the context of hierarchy trumps the context or relational closeness in shaping workers' confrontationality. Identity frames and the communication theory of identity (Hecht, 1993; Jung & Hecht, 2004) are used as lenses to understand the detected (and undetected) differences in participants' responses across workplace relationship types. [ABSTRACT FROM AUTHOR]

The authors review the publications on development, growth and survival of eukaryotic organisms. The topics of interest include gene regulation in these organisms and the study of one of the regulatory component- RNA polymerase II core promoter.

Recent study has shown the existence of transcriptional enhancers that are specific for promoters that contain either TATA box or downstream promoter element (DPE) elements. The core promoter is seen to mediate initiation of transcription and also to act as a regulatory element. The ability of enhancers to activate transcription in vivo from core promoters having either DPE or TATA box motifs was studied to look into the basis for enhancer-promoter specificity.

Complexes trans,trans,trans-[Pt(N3)2(OH)(OCOR)(py)2] where py = pyridine and where OCOR = succinate (1); 4-oxo-4-propoxybutanoate (2) and N-methylisatoate (3) have been synthesized by derivation of trans,trans,trans-[Pt(OH)2(N3)2(py)2] (4) and characterised by NMR and EPR spectroscopy, ESI-MS and X-ray crystallography. Irradiation of 1–3 with green (517 nm) light initiated photoreduction to Pt(II) and release of the axial ligands at a 3-fold faster rate than for 4. TD-DFT calculations showed dissociative transitions at longer wavelengths for 1 compared to 4. Complexes 1 and 2 showed greater photocytotoxicity than 4 when irradiated with 420 nm light (A2780 cell line IC50 values: 2.7 and 3.7 μM) and complex 2 was particularly active towards the cisplatin-resistant cell line A2780cis (IC50 3.7 μM). Unlike 4, complexes 1–3 were phototoxic under green light irradiation (517 nm), with minimal toxicity in the dark. A pKa(H2O) of 5.13 for the free carboxylate group was determined for 1, corresponding to an overall negative charge during biological experiments, which crucially, did not appear to impede cellular accumulation and photocytotoxicity. [ABSTRACT FROM AUTHOR]

Experiments demonstrate stable frequency and relative-phase angle output from twin traveling-wave tube (TWT) amplifiers driven with the redirected signal from a high-power backward-wave oscillator (BWO). The experimental X-band apparatus employs a single generator to produce three independent electron beams which simultaneously drive the BWO and TWT sources. The BWO spontaneously generates up to 14.1 MW peak, 25 to 15-ns long pulses over a current-tunable bandwidth of 9.6%. The BWO power extracted upstream is split and redirected into twin TWT's for amplification. The TWT's produce up to 9.0 MW pulses over an 800 MHz instantaneous bandwidth. Across the amplifier's full-width half-maximum pulse duration of 10 to 20 ns, a relative-phase angle of better than 15 [degrees] is maintained between TWT's for an 11.0 to 11.7 GHz range. Experiments characterize the gain, relative-phase angle, and efficiency of twin-TWT output as a function of RF-drive frequency and beam current. These experiments are the first to demonstrate the feasibility of relativistic TWT's for phased-array applications, and increase the limited data base documenting relativistic-TWT operation.

Background Hyponatraemia is a common problem in patients with heart failure. It can be difficult to treat, especially in the presence of the patient's needs for diuresis and manipulation of the renin–angiotensin–aldosterone system (RAAS). Case summary This concerns a 74-year-old woman with follicular lymphoma and severe global left ventricular systolic dysfunction secondary to treatment with R-CHOP chemotherapy. She presented a difficult challenge in the management of her decompensated heart failure alongside hyponatraemia as low as 113 mmol/L. This was resistant to standard treatment. The resistance to usual measures necessitated treatment with Tolvaptan, a selective arginine vasopressin V2 inhibitor used to treat hyponatraemia in syndrome of inappropriate anti-diuretic hormone. This, along with a strict fluid restriction of 500 mL/day, resolved the patient's hyponatraemia and enabled her discharge home on tolerated heart failure treatment. She has now remained stable for almost 12 months. Discussion The potential causes of hyponatraemia are discussed along with the role of Tolvaptan in its management. [ABSTRACT FROM AUTHOR]

Although most interpersonal interactions take place between people who know each other, most self-presentation research has focused on self-presentation to strangers. Five studies showed that self-presentational favorability differed as a function of whether the interaction partner was a friend or a stranger. Studies 1 and 2 found that self-presentations to friends were consistently more modest than self-presentations to strangers. In Studies 3 and 4, self-presentations were manipulated by instructing participants to present themselves in either a self-enhancing or modest manner. Modesty with strangers and self-enhancement with friends both resulted in impaired recall for the interaction, consistent with the view that those strategies contradict familiar, overlearned patterns. Study 5 distinguished self-deprecation from modesty. Taken together, the results indicate that people habitually use different self-presentation strategies with different audiences, relying on favorable self-enhancement with strangers but shifting toward modesty when among friends.

Experimental studies of two high-power backward-wave oscillators (BWO) functioning under Raman conditions at saturation amplitudes reveal that a BWO's nonlinear saturation properties depend on slow-wave structure length. Linear and nonlinear dynamics control BWO radio frequency characteristics. The nonlinear dynamics control saturation amplitudes and operational efficiency.